Taoiseach Leo Varadkar has expressed his sympathies to Alan Thawley, who lost his wife Malak to a surgical accident at the National Maternity Hospital in Holles Street last year.

Mr Varadkar, who was speaking in the Dáil, said maternal death is always "sad and tragic" and he indicated an external review may be possible.

Ms Thawley (34), who was undergoing a simple operation for ectopic pregnancy in May 2016, suffered a fatal haemorrhage after a major blood vessel was cut. Mr Thawley had been assured by staff that they do this procedure 30 to 40 times a week.

Mr Thawley yesterday repeated his call for an independent inquiry into his wife's death.

"One of the very big issues I have is that this hospital killed my wife through their multiple and serious failings - and they are the same people who have to give me all the evidence as to how my wife died," he told Pat Kenny on Newstalk radio.

He also called on Holles Street master Dr Rhona Mahony to make a public statement on the matter.

Recalling the day of surgery he said: "It was a little more than an hour after the surgery began and I still hadn't received an update and so that's when I was beginning to get worried.

"I did have some people who tried to come and give me an update, but the updates were extremely vague - I could tell they actually had no idea what was going on but they just wanted to talk to me". An inquest recorded "medical misadventure".

Responding to Fianna Fáil leader Micheál Martin, the Taoiseach said inquests by their nature are independent and are a court-like process.

He pointed out that an external case review could be carried out again and Health Minister Simon Harris said he would reflect on the request by Mr Thawley for an independent investigation.

A spokesman for Holles Street said the hospital has admitted responsibility for Ms Thawley's death through a terrible accident. He said Dr Mahony met Mr Thawley both on the night of the tragic death of his wife and the following day.

"She would very much like to have continued meeting with him, answering all the questions he had and providing some assistance as he began the grieving process following the devastating loss of his wife while she was in our care.

"However, we were instructed then by Mr Thawley's solicitor to have no further contact with him. We abided by this instruction, though felt then and still feel that ongoing contact with hospital staff would have allowed Mr Thawley to get a full understanding of what had happened.

"We believe the hospital report and the transcript of the inquest do answer many of the questions Mr Thawley clearly still has and clarifies the cause of death, which was a vascular accident for which the hospital has always admitted full liability.

"Our apology is heartfelt and repeated and our thoughts are with Mr Thawley. We understand that no words can bring Ms Thawley back."

Caoimhe Haughey, solicitor for Mr Thawley, said Dr Mahony had offered to meet him. However, his requests for specific information in advance of the meeting were not forthcoming and that is why it did not take place, she added.